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저자명
김태훈,조민정,박정준,김대연,김성철,김인구,Kim. Tae-Hoon,Cho. Min-Jeng,Park. Jeong-Jun,Kim. Dae-Yeon,Kim. Seong-Chul,Kim. In-Koo
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소아외과
권/호정보
2011년|17권 2호|pp.133-138 (6 pages)
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대한소아외과학회
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
서지반출

기타언어초록

Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{pm}1.7$ weeks and mean birth weight was $3031{pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{pm}0.96$ vs. $7.00{pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {pm}0.830$ vs. $7.159{pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{pm}7.9$ vs. $64.8{pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.